The Donovan Memorial Lecture: 'Fentanyl-Plus': A New Era of Fentanyl Polydrug Combinations in the North American Overdose Crisis.

The 2025 ACMT Ward and Ryan Donovan Memorial Fund lecture was presented by Daniel Ciccarone, MD, MPH from Department of Family and Community Medicine at the University of California San Francisco (UCSF). This article is an edited version of his keynote address during ACMT's 2025 Annual Scientific Meeting. During the course of his talk, Dr. Ciccarone discussed polysubstance use in the "Fentanyl-plus" era. The epidemiology and economics of the four waves of opioid overdose deaths were examined, and promising harm reduction strategies to assist in reducing overdose mortality were highlighted.